Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $141.25 / $169.82	Facility		$95.50	$141.25	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $13.18 / $47.86	Professional		$10.96	$13.18	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $16.98 / $21.38	Professional		$10.47	$16.98	$21.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $12.59 / $69.18	Facility		$12.59	$12.59	$69.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $14.45 / $57.54	Professional		$14.45	$14.45	$57.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $56.23 / $93.33	Facility		$50.12	$56.23	$93.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $32.36 / $32.36	Professional		$26.92	$32.36	$32.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $12.59 / $12.59	Facility		$12.59	$12.59	$12.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $14.45 / $18.62	Professional		$10.47	$14.45	$18.62
United Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $28.84 / $43.65	Professional		$9.12	$28.84	$43.65